T spine, L spine, Mechanics DSA Flashcards
Thoracic Vertebra (T1-12)
Body -medium size -heart shape -costal facets Spinous Process -long -slope posteroinferiorly
Lumbar Vertebra (L1-L5)
Body -large size -kidney shaped Spinous Process -short, broad
Vertebral Unit
Two adjacent vertebrae and their associated intervertebral discs
Rule of 3’s
Refers to the location of the spinous process in relation to the transverse process in the thoracic spine
T1-3, T12
Spinous process located AT THE LEVEL of the corresponding transverse process
T4-6, T11
Spinous process located 1/2 A SEGMENT BELOW the corresponding transverse process
T7-9, T10
Spinous process located AT THE LEVEL of the transverse process of the vertebrae ONE BELOW
Superior Facet Orientation: Cervical
BUM
Backwards, Upward, Medial
Superior Facet Orientation: Thoracic
BUL
Backward, Upward, Lateral
Superior Facet Orientation: Lumbar
BM
Backward, Medial
Anterior Longitudinal Ligament
Strong, broad, fibrous band that covers and connects the anterolateral aspects of the vertebral bodies and IV discs
Limits extension
Posterior Longitudinal Ligament
Narrower, somewhat weaker band that runs within the vertebral canal along the posterior aspect of the vertebral bodies
Resists hyperflexion
Prevents posterior herniation of nucleus pulposus
Ligamentum Flava
Connect the laminae of adjacent vertebrae
Interspinous Ligaments
Connects adjoining spinous processes
Intertransverse Ligaments
Connects adjoining transverse processes
Rotatores
Rotatores Brevis: T1-T12 between transverse and spinous processes of adjacent vertebrae
Rotatores Longus: T1-T12 between transverse and spinous processes, skipping one vertebra
Bilateral: extend thoracic spine
Unilateral: rotate thoracic spine to opposite side
Multifidus
Origin: sacrum, ilium, mammillary processes of L-L5, transverse and articular facets
Insertion: superomedially to spinous processes, skipping two to four vertebrae
Innervation: spinal nerve
Bilateral: extends spine
Unilateral: flexes spine to same side, and rotates it to opposite side
Semispinalis
Capitis: C4-T7 to occipital bone
Cervicis: T1-T6 transverse processes to C2-C5 spinous processes
Thoracis: T6-T12 transverse processes to C6-T4 spinous processes
Innervation: spinal nerve
Bilateral: extends thoracic and cervical spines and head
Unilateral: bends head, cervical, and thoracic spines to same side, rotates to opposite side
Vertebral Motion: Flexion
S1-vertical, C7
40-90 degrees
Vertebral Motion: Extension
S1-vertical, C7
20-45 degrees
Vertebral Motion: Sidebending
S1-vertical, C7
15-30 degrees
Vertebral Motion: Rotation
Central of head- acromion, ASIS
3-18 degrees
Coupled Motion (Motion Principle #3)
Consistent association of a motion along or about one axis, with another motion about or along a 2nd axis
Motion cannot be produced without the associated motion occurring as well
Linkage
Relationship of joint mechanics with surrounding structures
By linking structures together there is an increased ROM
Specific joint assessment requires joint isolation for accurate measurement and evaluation
Functional assessment of a joint may asses linkage
Normal vs. result of compensation
Vertebral Nomenclature
Motion is always referenced to the movement of the anterior/superior surface of the vertebrae
Excessive motion or restriction is in reference to the vertebra ABOVE in a functional vertebral unit (Ie. excess motion of L2 is the motion of L2 on L3)
Physiological Barriers
Limit of active motion
Anatomic Barrier
Limit of motion imposed on anatomic structure
Limit of passive motion
Elastic Barrier
Range between the physiologic and anatomic barrier of motion in which passive ligamentous stretching occurs before tissue disruption
Restrictive Barrier
Functional limit within the anatomic range of motion
Abnormally diminishes the normal physiologic range
Why does spinal somatic dysfunction matter?
Restrictions of motion in the spine
- reduce efficiency
- impair flow of fluids
- alter nerve functions
- create structural imbalance
Fryette’s Principles
Harrison Fryette, DO
Described physiologic motion of the spine
Published in 1918
Developed two principles of spinal motion applicable to the thoracic and lumbar spine
Who developed the 3rd principle and in what year?
C.R. Nelson, DO
1948
Fryette: Type One Spinal Mechanics
Neutral Range:
Sidebending and Rotation = OPPOSITE
Rotation is towards the convexity of the spine
Tends to be a GROUP of vertebra
Fryette: Type One Mnemonic
TONGO Type One Neutral Group Opposite
Fryette: Type Two Mechanics
Flexion or Extension:
Sidebending and Rotation = SAME direction
Rotation towards the concavity
Tends to be SINGLE vertebra
Spinal Curvature
Cervical and Lumbar = Concave, Lordosis
Thoracic and Sacral = Convex, Kyphosis
Fryette: Type Two Mnemonic
TTOSS Type Two Non-Neutral Single Segment Same Direction
Somatic Dysfunction Nomenclature: Type One
1) Locate vertebra or group (T1-3)
2) Indicate position (N- neutral)
3) Indicate sidebending (Sr- sidebent right; restricted to left sidebending)
4) Indicate rotation (Rl- rotated left; restricted to right rotation)
T1-3 NSrRl
Somatic Dysfunction Nomenclature: Type Two
1) Locate vertebra or group (T9)
2) Indicate position (F-flexion; or E-extension)
3) Indicate sidebending (Sl- sidebent left; restricted to right sidebending)
4) Indicate rotation (Rl- rotated left; restricted to right rotation)
T9 FSlRl
Fryette: 3rd Principle (Nelson’s Principle)
Initiating movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion
If motion is restricted in one direction, motion will also be restricted in other directions
If motion is improved in one direction, motion will improve in other directions
Fryette’s Principles Summary:
Type 1 and Type 2 principles only pertain to thoracic and lumbar spine
Nelson’s principle is universal
Testing Rotation SD
Push anterior on RIGHT transverse process > Vertebra rotates LEFT
Push anterior on LEFT transverse process > Vertebra rotates RIGHT
(Think bike handles)
Equivalent Terms (Rotated Right SD)
Posterior Transverse Process (PTP) on the right Right PTP Rotated Right Hard end feel with rotation to left Hard end feel on the right (when applying anterior force to the right transverse process) Restricted to rotation to the left Will not rotate to the left Lives in right rotation Held to the right
Sidebending
Sidebent Right:
Resistance encountered when attempting to translate to the right
Ease of motion is felt with translation to the left
Right Sidebending Dysfunction
Translation to the left induces right sidebending
Translation to the right induces left sidebending
Spinal Landmarks
Spine of the scapula: T3 spinous process and transverse process
Inferior angle of the scapula: Spinous process of T7 and transverse process of T8
Iliac Crest: level of L4
